Hospitalization because of bleeding from the stomach or esophagus occurred 4.8 times per million person-days among persons over 64 years of age who filled a prescription for nonsteroidal anti-inflammatory drugs (NSAIDs) within 90 days of hospitalization, and 3.4 times per million person-days among nonusers of NSAIDs over 64 years of age at the Group Health Cooperative of Puget Sound, Seattle. The NSAID users included those who had used these drugs on a long-term basis as well as those who were recent users only. The observed difference in rates (1.3 hospitalizations per million person-days; 95% confidence interval, -0.2 to 3.4 hospitalizations per million person-days) is incompatible with any major increase in the frequency of hospitalization for gastroesophageal bleeding in the elderly. No single NSAID appeared to carry an exceptional risk. Both chance and uncontrollable selection factors could provide plausible explanations for the small rate differences observed between users and nonusers.